Squamous cell carcinoma of the lung echocardiography or ultrasound: Difference between revisions

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==Overview==
==Overview==
On endobronchial and endoscopic ultrasound, characteristic findings of squamous cell carcinoma of the lung, include: enlarged lymph nodes and local invasion to adjacent bronchial structures and mediastinum. Endobronchial ultrasound is a first-line diagnostic modality for mediastinal staging.
On endobronchial and endoscopic ultrasound, characteristic findings of squamous cell carcinoma of the lung, include: enlarged [[Lymph node|lymph nodes]] and local invasion to adjacent [[bronchial]] structures and [[mediastinum]]. Endobronchial ultrasound is a first-line diagnostic modality for mediastinal staging.


==Ultrasound==
==Ultrasound==
*Endobronchial ultrasound is a first-line diagnostic modality for mediastinal staging.<ref name="pmid24484269">{{cite journal |vauthors=Kinsey CM, Arenberg DA |title=Endobronchial ultrasound-guided transbronchial needle aspiration for non-small cell lung cancer staging |journal=Am. J. Respir. Crit. Care Med. |volume=189 |issue=6 |pages=640–9 |year=2014 |pmid=24484269 |doi=10.1164/rccm.201311-2007CI |url=}}</ref>
*Endobronchial ultrasound is a first-line diagnostic modality for mediastinal staging.<ref name="pmid24484269">{{cite journal |vauthors=Kinsey CM, Arenberg DA |title=Endobronchial ultrasound-guided transbronchial needle aspiration for non-small cell lung cancer staging |journal=Am. J. Respir. Crit. Care Med. |volume=189 |issue=6 |pages=640–9 |year=2014 |pmid=24484269 |doi=10.1164/rccm.201311-2007CI |url=}}</ref>
*Common features of endobronchial ultrasound, include: <ref name="cancer">Tests for non-small cell lung cancer. American Cancer Society. http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-diagnosis Accessed on February 25, 2016</ref>  
*Common features of endobronchial ultrasound, include: <ref name="cancer">Tests for non-small cell lung cancer. American Cancer Society. http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-diagnosis Accessed on February 25, 2016</ref>  
:*Evaluation of lymph nodes and other structures in the mediastinum  
:*Evaluation of [[lymph nodes]] and other structures in the [[mediastinum]]
:*Mediastinum invasion staging  
:*[[Mediastinum]] invasion staging  
:*Determination of management strategy  
:*Determination of management strategy  
:*Real time evaluation of structures
:*Real time evaluation of structures
:*Sensitivity 90% and specificity of 97%
:*Sensitivity 90% and specificity of 97%
*On ultrasound (endobronchial ultrasound), characteristic findings of squamous cell carcinoma of the lung, include: <ref name="lung cancer">Lung cancer staging. Wikipedia. https://en.wikipedia.org/wiki/Lung_cancer_staging Accessed on February 25,2016</ref>
*On ultrasound (endobronchial ultrasound), characteristic findings of squamous cell carcinoma of the lung, include: <ref name="pmid17296659">{{cite journal |vauthors=Micames CG, McCrory DC, Pavey DA, Jowell PS, Gress FG |title=Endoscopic ultrasound-guided fine-needle aspiration for non-small cell lung cancer staging: A systematic review and metaanalysis |journal=Chest |volume=131 |issue=2 |pages=539–48|date=February 2007 |pmid=17296659|doi=10.1378/chest.06-1437|url=http://www.chestjournal.org/cgi/content/full/131/2/539}}</ref><ref name="pmid17589301">{{cite journal |vauthors=Kim ES, Bosquée L |title=The importance of accurate lymph node staging in early and locally advanced non-small cell lung cancer: an update on available techniques |journal=J Thorac Oncol |volume=2 Suppl 2 |issue= |pages=S59–67 |date=June 2007 |pmid=17589301 |doi=10.1097/01.JTO.0000269738.13586.fd |url=}}</ref><ref name="Wiersema">Wiersema M et al. Real-time endoscopic ultrasound-guided fine-needle aspiration of a mediastinal lymph node. Gastrointest Endosc 1993, 39(3):429-431</ref>
:*Enlarged lymph nodes  
:*[[Lymphadenopathy|Enlarged lymph nodes]]
:*Local invasion to adjacent bronchial structures and mediastinum
:*Local invasion to adjacent bronchial structures and [[mediastinum]]
* The table below summarizes the advantages and disadvantages of both ultrasound modalities, for the diagnostic assessment of non-small cell lung cancer.  
* The table below summarizes the advantages and disadvantages of both ultrasound modalities, for the diagnostic assessment of non-small cell lung cancer.<ref name="pmid18252884">{{cite journal  |vauthors=Wallace MB, Pascual JM, Raimondo M, etal |title=Minimally invasive endoscopic staging of suspected lung cancer |journal=JAMA |volume=299 |issue=5 |pages=540–6 |date=February 2008 |pmid=18252884 |doi=10.1001/jama.299.5.540 |url=}}</ref><ref name="Singh">Singh P et al. Endoscopic ultrasound as a first test for diagnosis and staging of lung cancer: a prospective study. Am J Respir Crit Care Med 2007, 175(4):345-354.</ref><ref name="Cerfolio">Cerfolio R, Bryant A, Ojha B: Restaging patients with N2 (stage IIIa) non-small cell lung cancer after neoadjuvant chemoradiotherapy: a prospective study. J Thorac Cardiovasc Surg 2006, 131(6):1229-1235</ref><ref name="Yasufuku">Yasufuku K et al. Endobronchial ultrasonography: current status and future directions. J Thorac Oncol 2007, 2(10):970-979.</ref>


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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |  Endobronchial ultrasound (EBUS)
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |  Endobronchial ultrasound (EBUS)
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*Direct visualization of lymph node stations.  
*Direct visualization of [[lymph node]] stations.  
*Complements endoscopic ultrasound: covers lymph node stations 2R and 4R which are difficult to access by endoscopic ultrasound
*Complements [[endoscopic ultrasound]]: covers lymph node stations 2R and 4R which are difficult to access by endoscopic ultrasound
*Lower false-negative rate than with blind transbronchial fine needle aspiration and fewer complications
*Lower false-negative rate than with blind transbronchial [[Needle aspiration biopsy|fine needle aspiration]] and fewer complications
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*More invasive than endoscopic ultrasound, few practitioners, but rapidly growing in popularity
*More [[invasive]] than [[endoscopic ultrasound]], few practitioners, but rapidly growing in popularity
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |  [[Endoscopic ultrasound]] (EUS)
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |  [[Endoscopic ultrasound]] (EUS)
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*Least invasive modality
*Least invasive modality
*Uses the esophagus to access mediastinal lymph nodes
*Uses the [[esophagus]] to access [[Mediastinal lymph node|mediastinal lymph nodes]]
*Excellent for staging lymph nodes
*Excellent for staging [[Lymph node|lymph nodes]]
*Useful for station 2L and 4L, L adrenal, celiac lymph node
*Useful for station 2L and 4L, L [[adrenal]], [[celiac]] [[lymph node]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*Cannot reliably access right sided paratracheal lymph node stations 2 R and 4R
*Cannot reliably access right sided [[Paratracheal lymph nodes|paratracheal lymph node]] stations 2 R and 4R
*Accurate discrimination of primary hilar tumors and involved lymph nodes is important
*Accurate discrimination of primary [[Hilum|hilar]] tumors and involved [[lymph nodes]] is important
|}
|}


Latest revision as of 02:26, 29 April 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

On endobronchial and endoscopic ultrasound, characteristic findings of squamous cell carcinoma of the lung, include: enlarged lymph nodes and local invasion to adjacent bronchial structures and mediastinum. Endobronchial ultrasound is a first-line diagnostic modality for mediastinal staging.

Ultrasound

  • Endobronchial ultrasound is a first-line diagnostic modality for mediastinal staging.[1]
  • Common features of endobronchial ultrasound, include: [2]
  • Evaluation of lymph nodes and other structures in the mediastinum
  • Mediastinum invasion staging
  • Determination of management strategy
  • Real time evaluation of structures
  • Sensitivity 90% and specificity of 97%
  • On ultrasound (endobronchial ultrasound), characteristic findings of squamous cell carcinoma of the lung, include: [3][4][5]
  • The table below summarizes the advantages and disadvantages of both ultrasound modalities, for the diagnostic assessment of non-small cell lung cancer.[6][7][8][9]
Procedure Advantages Disadvantages
Endobronchial ultrasound (EBUS)
  • Direct visualization of lymph node stations.
  • Complements endoscopic ultrasound: covers lymph node stations 2R and 4R which are difficult to access by endoscopic ultrasound
  • Lower false-negative rate than with blind transbronchial fine needle aspiration and fewer complications
Endoscopic ultrasound (EUS)

Gallery

  • Doppler endoscopic ultrasound: mediastinal lymph node via, en.wikipedia.org[10]

    Doppler endoscopic ultrasound: mediastinal lymph node via, en.wikipedia.org[10]

  • Endoscopic ultrasound: A biopsy window is found and an fine needle aspiration advanced into the massvia, en.wikipedia.org[11]

    Endoscopic ultrasound: A biopsy window is found and an fine needle aspiration advanced into the massvia, en.wikipedia.org[11]

  • Endoscopic ultrasound: A lung mass which is partially behind the aorta is seen with endoscopic ultrasound, via Wikimedia Commons[12]

    Endoscopic ultrasound: A lung mass which is partially behind the aorta is seen with endoscopic ultrasound, via Wikimedia Commons[12]

References

  1. ↑ Kinsey CM, Arenberg DA (2014). "Endobronchial ultrasound-guided transbronchial needle aspiration for non-small cell lung cancer staging". Am. J. Respir. Crit. Care Med. 189 (6): 640–9. doi:10.1164/rccm.201311-2007CI. PMID 24484269.
  2. ↑ Tests for non-small cell lung cancer. American Cancer Society. http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-diagnosis Accessed on February 25, 2016
  3. ↑ Micames CG, McCrory DC, Pavey DA, Jowell PS, Gress FG (February 2007). "Endoscopic ultrasound-guided fine-needle aspiration for non-small cell lung cancer staging: A systematic review and metaanalysis". Chest. 131 (2): 539–48. doi:10.1378/chest.06-1437. PMID 17296659.
  4. ↑ Kim ES, Bosquée L (June 2007). "The importance of accurate lymph node staging in early and locally advanced non-small cell lung cancer: an update on available techniques". J Thorac Oncol. 2 Suppl 2: S59–67. doi:10.1097/01.JTO.0000269738.13586.fd. PMID 17589301.
  5. ↑ Wiersema M et al. Real-time endoscopic ultrasound-guided fine-needle aspiration of a mediastinal lymph node. Gastrointest Endosc 1993, 39(3):429-431
  6. ↑ Wallace MB, Pascual JM, Raimondo M, et al. (February 2008). "Minimally invasive endoscopic staging of suspected lung cancer". JAMA. 299 (5): 540–6. doi:10.1001/jama.299.5.540. PMID 18252884.
  7. ↑ Singh P et al. Endoscopic ultrasound as a first test for diagnosis and staging of lung cancer: a prospective study. Am J Respir Crit Care Med 2007, 175(4):345-354.
  8. ↑ Cerfolio R, Bryant A, Ojha B: Restaging patients with N2 (stage IIIa) non-small cell lung cancer after neoadjuvant chemoradiotherapy: a prospective study. J Thorac Cardiovasc Surg 2006, 131(6):1229-1235
  9. ↑ Yasufuku K et al. Endobronchial ultrasonography: current status and future directions. J Thorac Oncol 2007, 2(10):970-979.
  10. ↑ https://en.wikipedia.org/wiki/File:Eus_doppler_mediastinal_lymph_node.JPG#file
  11. ↑ https://en.wikipedia.org/wiki/File:Lul_mass_linear_eus_1.jpg
  12. ↑ href="https://en.wikipedia.org/wiki/User:Ktg_usa" class="extiw" title="en:User:Ktg usa">Ktg usa</a> at the <a href="https://en.wikipedia.org/wiki/" class="extiw" title="en:">English language Wikipedia</a> [<a href="http://www.gnu.org/copyleft/fdl.html">GFDL</a> or <a href="http://creativecommons.org/licenses/by-sa/3.0/">CC-BY-SA-3.0</a>], <a href="https://commons.wikimedia.org/wiki/File%3ALul_mass_radial_eus.jpg">


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